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Tyler

+2k šŸ’¼ Jobs / Employment in Tyler, TX

RN Clinical Appeals - Patient Financial Support - Tyler
newabout 19 hours ago
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Description Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. The Clinical Appeals Nurse will review each case identified/referred for appeal based on Milliman Care Guidelines (MCG), InterQual, and/or other relevant guidelines, determined the viability of the appeal, and manage the appeal process. The Clinical Appeals Nurse is responsible for appealing all inappropriate denials through all possible levels of the appeal process. The RN Clinical Appeals Nurse will actively manage, maintain and communicate denial/appeal activity to appropriate stakeholders, and report suspected or emerging trends related to payer denials. Working with Case Management leadership, this individual will orchestrate education and other performance improvement initiatives to impact clinical quality, improve efficiency and mitigate lost revenue related to medical necessity denials. Key Performance and trends related to denials/appeals will be reported to the facility. The RN Clinical Appeals Nurse will perform duties aimed at denials prevention and billing compliance. Requirements A. Education/Skills Graduate of an accredited School of Nursing with a Bachelor's degree in nursing is preferred; associates degree in nursing accepted with strong clinical experience. Excellent verbal and written communication skills, strong listening skills, critical thinking and analytical skills, problem solving skills, ability to set priorities and multi-task Ability to communicate with multiple levels in the organization (e.g. managers, physicians, clinical and support staff). Ability to maintain a strong relationship with the medical staff and work collaboratively to positively affect clinical and financial outcomes Assertive and diplomatic communication, proven ability to function on a multidisciplinary team. Excellent organizational skills including effective time management, priority setting and process improvement. B. Experience Two to four years of Utilization Review/Case Management experience strongly preferred. Two to three years' experience in the denial and appeal process strongly preferred (clinic or hospital) Experience with managed care, governmental and/or RAC appeals strongly preferred. Knowledgeable of InterQual and Milliman Care Guidelines (MCG) medical necessity criteria Understanding of Medicare, Medicaid and third party reimbursement methodologies. Computer experience in Microsoft Office (Word and Excel). C. Licenses, Registrations, or Certifications: Current RN Nursing license Interqual and/or MCG certification preferred. Case Management certification preferred

Customer Relations Specialist
7 days ago
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Local company is seeking a Customer Relations Specialist to join their team! The perfect candidate will have a primary focus in developing new business sales through quality prospecting andĀ ...

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PRN ekg tech
newabout 12 hours ago
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Details The EKG Technician is responsible for obtaining high quality EKG s, holter monitoring, and signal average EKG studies along with other ancillary

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Customer Service Assistant - Entry Level
8 days ago
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We provide customers with the everyday value and uncompromising customer service that has made us so successful. We are now accepting applications for Customer Service and Brand representatives. Be aĀ ...

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Emergency transfer coordinator rn
newabout 15 hours ago
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Details: The shift for this position is rotating 12 hour shifts, 6p-6a Responsible for emergency patient transfer coordination and communications for the

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Retail Customer Service Representative
28 days ago
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Retail Customer Service Representative - Hiring Now for the New Year Join this dynamic store team and you will have the opportunity to perform a wide range of retail functions ensuring that theĀ ...

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PRN patient care tech float pool
newabout 15 hours ago
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Details: The Patient Care Assistant is responsible for providing technical and human assistance under the direction of licensed personnel to provide care

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Face to Face Customer Service Specialist - Full Time
30 days ago
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Customer Service Representative You'll be responsible for providing a high-quality service to our customers & you will keep treating customers fairly at the heart of everything you do. To apply forĀ ...

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E. p. lab rn
newabout 14 hours ago
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Details The Electrophysiology Lab Registered Nurse assists the Cardiologist with procedures performed in the Electrophysiology Lab, such as invasive/non-invasive

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CDL A or B Team Drivers - FedEx Custom Critical- Straight Truck 40FT
8 days ago
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No Single Drivers for this Position !!!! Over-the Road Teams Straight Truck (40FT) Dry Van Border 2 Border Logistics is looking for highly motivated team drivers to become part of our team. We areĀ ...

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Charge nurse neuro icu
newabout 13 hours ago
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Details Coordinates and administers care to a unit specific patient population utilizing a collaborative, multidisciplinary approach to ensure that each

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Class A CDL Regional/Dedicated Company Driver Home Weekends
9 days ago
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Great Account Runs .Home every weekend Company drivers 6 months Class A CDL Experience STUDENTS WELCOME!!!! Take truck home on off time Company drivers average $1057.00 to $1,250.00 and up per weekĀ ...

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STAFF PHYSICIAN PRIMARY CARE
newabout 19 hours ago
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Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed. Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. Completion of residency training, or its equivalent, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification. Proficiency in spoken and written English. Physical requirements outlined below. Preferred Experience: Board eligible/board certified in family practice or internal medicine. Possess 2-3 years clinical experience. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-2 Physician Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Selectee should be physically and mentally capable to perform the duties of the position including examinations, formulate the diagnosis and treatment plan. Physical activities include sitting, standing (up to 4 hours) walking (up to 2 hours), heavy lifting (45 pounds or over), reaching above the shoulder, and repeated bending. The incumbent should be emotionally and mentally stable; and capable to perform the duties of the position. For additional information on Physical Standards please see VA Directive and Handbook 5019. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recrui

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Retail Customer Service Associate- NOT a call center!
about 2 months ago
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If you have great people skills and enjoy working with the public, we want to meet you! We have full-time positions available for career minded individuals with unbeatable people skills. This is anĀ ...

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Staff physician primary care
newabout 14 hours ago
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Basic Requirements United States Citizenship Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with

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Guest Experience Representative - Customer Service
about 2 months ago
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The Dufresne Spencer Group, the largest owner of Ashley Furniture HomeStores has an immediate opening for Guest Experience Representative. We offer generous vacation packages, employee furnitureĀ ...

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Desktop technician
newabout 13 hours ago
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Kforce is in search of Computer Technicians near Tyler, Texas (TX) to assist our client on a large Windows 10 PC refresh and software deployment project

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LOCAL PICK UP & DELIVERY DRIVER - HOME NIGHTLY -CLASS A CDL
14 days ago
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SEE WHAT YOU'VE BEEN MISSING Central Freight Lines offers Pick-Up/Delivery Drivers great pay and an exceptional work environment! You may not even know it, but Central Freight Lines is one of the topĀ ...

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Cardiac imc rn
newabout 12 hours ago
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Details 5N CV IMC serves patients requiring an intermediate level of cardiac care and recovering from a cardiac intervention. The Registered Nurse (RN)

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Truck Driver - Flexible Home Time - Up to $10k Sign On - Top Benefits
16 days ago
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Now Hiring CDL-A Dedicated Drivers! Up to $10,000 Sign On - Excellent Pay + Benefits **Recent Grads Welcome! Ask about our industry leading training and opportunities for quick growth** Driving aĀ ...

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Specialty clinical nurse general neuro/neuro icu
newabout 12 hours ago
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Details The Specialty Clinical Nurse provides experienced nursing clinical expertise in a focus area to promote standards of practice and continuity of

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Community Coordinator Assistant, Non-Profit
9 days ago
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Community Coordinator Assistant, Non-Profit Brelsford Personnel has been tasked to find a highly skilled professional administrative assistant who can serve in a support role within a non-profitĀ ...

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Charge nurse neurology
newabout 11 hours ago
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Details Coordinates and administers care to a unit specific patient population utilizing a collaborative, multidisciplinary approach to ensure that each

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Truck Driver - Earn up to 47 CPM + Top Benefits - Recent Grads Welcome
28 days ago
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CFI is Looking for Recent Grads! Excellent Pay and Benefits - Reliable Home Time Solo and Team Opportunities Available CFI offers several routes to becoming a professional Regional or Over-the-Road Ā ...

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Draftsmen, Cabinets
newabout 19 hours ago
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B and L Cabinets looking for draftsman with some experience with cabinetware or cabinet vision. AUTOCAD a plus. Excellent salary with benefits. Please call 903-738-9598. Tyler Morning Telegraph. Keywords: Drafter, Location: Tyler, TX - 75701

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Sales Account Executive - Outside Sales Representative
new2 days ago
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WORK IN CHURCHES!! BASE PLUS COMMISSION! Enhance your personal ministry by promoting our church directory program. Remember Church Directories has immediate openings in your area for SALESĀ ...

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Haul Driver, Class A
newabout 19 hours ago
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Welch Excavation And Utility Company Inc. Haul Driver, Class A Class A Heavy Haul Driver wanted for excavation company in East Texas. Must have experience operating, loading and unloading large earthmoving equipment including excavators, dozers and rollers. Should have experience with oversized loads. Travel includes interstate. We offer a newer model haul truck, competitive wages and benefits. Contact Clint 903-877-3528 or visit our website www.welchexcavation.net Tyler Morning Telegraph. Keywords: Class A Driver, Location: Tyler, TX - 75701

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TRUCK DRIVER CDL CLASS A
about 1 month ago
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We are seeking a CDL CASS A TRUCK DRIVER to join our team! You will be responsible for safely operating a truck with a capacity of at least 26,000 pounds Gross Vehicle Weight (GVW). Responsibilities

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Medical Case Manager
newabout 19 hours ago
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MEDICAL CASE MANAGER needed to work with HIV positive clients in Tyler. Bilingual preferred. Bachelorā€™s degree required, must have 2 years experience in social services. Salary DOE. To apply, visit www.specialhealth.org or send resume to hrshrt.net , FAX 903-212-7899. Tyler Morning Telegraph. Keywords: Medical Case Manager, Location: Tyler, TX - 75701

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āœ” Outside Sales - NO PROSPECTING
7 days ago
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We're an established, family owned company that services the estate planning needs of seniors 60 and older. We are looking for an experienced producer of integrity who is looking for their lastĀ ...

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Full & Part time Security Officers
newabout 19 hours ago
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Need Full & Part time Security Officers. Commissioned and Non Commissioned. Call Dean Rivard any day 3p-6p for more information. 903-236-4700. Drug Screen & Background Check required. Tyler Morning Telegraph. Keywords: Security Guard, Location: Tyler, TX - 75701

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Junior Account Executive
7 days ago
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Junior Account Executive As a result of current economic conditions, our clients are looking for viable alternatives to their current benefit programs and the demand for our products and services hasĀ ...

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